- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,988.56 / $27,605.70 / $53,398.33
| Facility | | $20,988.56 | $27,605.70 | $53,398.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $919.38 / $1,375.01 / $13,909.00
| Facility | | $919.38 | $1,375.01 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,448.57 / $1,800.17 / $2,425.82
| Facility | | $1,448.57 | $1,800.17 | $2,425.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |